Kornimate/medical-research-clean huggingface dataset:
tourniquets increase proximal pressure

Conditions: Blood Pressure

Summary: there is an urgent clinical need to improve survival and neurologic outcomes after cardiac arrest. when a patient goes into cardiac arrest, cardiopulmonary resuscitation (cpr) with chest compressions is the current standard of care treatment to mechanically circulate blood through the patient's body. the immediate and long-term success of cpr is critically dependent on the maintenance of adequate coronary and cerebral perfusion. the investigators propose that cpr outcomes can be improved by capitalizing on the innate mechanism of vasoconstriction and preferentially routing the limited oxygenated blood to the heart and brain. the proposed solution is occlusion of extremity vasculature will increase coronary and cerebral perfusion and improve patient outcomes after cardiac arrest. prior research has investigated the efficacy of manipulating peripheral vascular resistance with tourniquets in animal studies with improved cardiac and cerebral perfusion and survival. to prove this is an adequate solution in humans, the investigators plan to use tourniquets on the legs to occlude the peripheral vasculature in healthy humans and measure more proximal blood pressure before and after tourniquet deployment. proof of concept of this solution will make way for development of novel devices for use during cardiac arrest and cpr to improve heart and brain perfusion and ultimately improve cardiac arrest outcomes. the investigators will recruit 30 healthy human participants and measure their blood pressure in their arm. they will then place two commercially-available, fda-approved tourniquets around each thigh to stop blood flow to the legs. the investigators will measure the blood pressure in the arms again. they will then release the tourniquets after blood pressure measurement. this will be repeated three times with breaks between each repetition.


Eligibility criteria:
inclusion criteria: * healthy adults with no known chronic medical conditions between the ages of 18 and 60 years old willing and able to consent themselves. * subjects who are native english speakers or self-report as fluent in english. exclusion criteria: * subjects who have a history of or are a current smoker, have a history of or current illicit drug use, have a history of or current alcohol abuse. * subjects who self-report as pregnant. * subjects who self-report diabetes, cardiac disease including hypertension requiring medication, or a history of compartment syndrome or peripheral vascular disease. * subjects with known chronic diseases not listed above, including but not limited to rheumatoid arthritis, mcardle's disease, etc. * subjects with elevated blood pressure (\>130/80mmhg) on the day of the study
a double-blind study to investigate efficacy, safety and tolerability of bay1142524 in patients with type ii diabetes and a clinical diagnosis of diabetic kidney disease

Conditions: Diabetic Kidney Disease

Summary: the purpose of the trial is the analysis of safety and efficacy of the chymase inhibitor bay1142524 at a dose of 25 mg bid in comparison to placebo using a 6 months treatment period in type ii diabetic patients with a clinical diagnosis of diabetic kidney disease. bay1142524 or placebo will be given on top of evidence-based standard of care for diabetic kidney disease. primary objective is the analysis of first signs of efficacy as determined by favourable changes in urinary albumin creatinine ratio. secondary objective is the analysis of safety and tolerability as evidenced by the incidence and severity of adverse events. 64 valid patients have to complete treatment with verum and 32 valid patients have to complete treatment with placebo.


Eligibility criteria:
inclusion criteria: * patients with type 2 diabetes mellitus and a clinical diagnosis of diabetic kidney disease (dkd) (as judged by the investigator) who have finished their up-titration with an angiotensin receptor blocker (arb) or an acei (angiotensin-converting enzyme inhibitor) to their maximum tolerated dose at least 3 months prior to the screening visit, whereby the maximum tolerated dose has to be at least as high as the minimal recommended dose of an arb or acei according to local and/or international guidelines. patients have to be treated with an arb or acei, but not with both simultaneously, without any adjustments to this therapy for at least 4 weeks prior to the screening visit. * uacr \>50 mg/g and \<3000 mg/g in 2 out of 3 consecutive morning void samples at the screening and the baseline visit * estimated glomerular filtration rate (egfr) ≥30 ml/min/1.73 m\*2 and \<90 ml/min/1.73 m\*2 (chronic kidney disease epidemiology collaboration \[ckd-epi\]) at the screening visit and the baseline visit exclusion criteria: * non-dkd if it is the main diagnosis contributory to chronic kidney disease (ckd), as judged by the investigator * known bilateral clinical relevant renal artery stenosis (\>75%) * new york heart association (nyha) class iv * acute kidney injury or dialysis within the last 3 months before the screening visit * renal replacement therapy during study conduct * renal allograft in place or a scheduled kidney transplant during study conduct * stroke, transient ischemic cerebral attack, acute coronary syndrome, or hospitalization for heart failure in the last 3 months prior to screening visit * clinically relevant hepatic dysfunction * uncontrolled hypertension as evidenced by systolic blood pressure \>160 mmhg, diastolic blood pressure \>100 mmhg (mean of triplicate values at the screening or baseline visit)

Keywords: type ii diabetes diabetic kidney disease
radiological vs clinical outcome in drf

Conditions: Distal Radius Fracture

Summary: background: several studies have investigated the degree of final displacement and its association with clinical outcome. there is still no consensus on the importance of radiological outcome and published studies do not use the same criteria for an acceptable alignment. previous reports have used a linear or a dichotomized exposure in the statistical analysis, but no study has investigated a nonlinear association. methods: we included 438 patients treated for a distal radius fracture (drf) with either reduction and cast immobilization or surgery. radiographic outcomes were determined by radiographs 3 months after the injury. clinical outcome was determined by quickdash (qdash), rom and grip strength at 1-year after the injury. nonlinear correlations were analysed with cubic splines.


Eligibility criteria:
inclusion criteria: - patients with distal radius fracture between 15 and 74 years, with closed physes of the distal radius and ulna. exclusion criteria: * dementia * previous fracture to the ipsilateral wrist * open fracture * other concomitant or existing damage or injury to the wrist * galeazzi fracture * rheumatoid arthritis * alcohol or drug abuse * neurologic impairment
adhesiveness of coronary drug-eluting stents to the delivery balloon-catheter: a randomized comparison

Conditions: Coronary Artery Disease

Summary: this study will evaluate the 3 drug-eluting stents presently marketed for intervention in the coronary artery with respect to the complications that may occur in case it becomes necessary to retract the stent during the intervention. it has been noted that stents carrying a drug for local application may be more difficult to retract than the more smooth bare metal stents.

patients in whom des implantation is planned will be randomized to one of the 3 commercially available stents (i.e., cypher, taxus-liberté, endeavor). sealed envelopes will be used for randomization purposes. should additional stents be required in the same patient for the same or other lesions, another stent of the same type of stents will be implanted. the following assessments will be made: * unblinded subjective operator assessment based on a questionnaire. the questionnaire will include questions on problems encountered during stent-balloon retrieval, special maneuvers performed (e.g., retrieval of the catheter during device removal, and possible complications associated with device retrieval). * blinded measurements of following parameters: 1. minimal and maximal distance between the tip of the guiding catheter and the proximal stent end during stent-balloon retrieval. 2. minimal and maximal distance between the tip of the guidewire and the distal portion of the stent during stent-balloon retrieval. 3. to do so the retrieval of the stent-balloon will be documented on ciné-angiography. the measurements will be performed by a qualified technician/physician blinded to the type of device used. * clinical endpoints: d. in-hospital mortality, myocardial infarction, or need for unplanned urgent repeat revascularization. e. myocardial infarction defined as creatine kinase mb-isoform \[ck-mb\] ≥3x upper limit of normal within 24 hours of the procedure or ≥2x upper limit of normal after 24 hours of the procedure in the presence of new ischemic symptoms. * target enrollment of 150 patients

Eligibility criteria:
inclusion criteria: * patients with a planned angiography and percutane coronary intervention * age 18 years or above * informed consent to pci and to participation in this trial exclusion criteria: * patients who after angiography are deemed not suitable for stent implant (operators discretion)

Keywords: des (drug eluting stents) cad (cornary artery disease) stent retrieval
constraint-induced movement therapy (cimt) and bimanual training (habit) in children with hemiplegic cerebral palsy

Conditions: Cerebral Palsy; Hemiplegia; Children; Pediatric

Summary: a randomized control trial of bimanual training. the protocols have been developed at columbia university to be child friendly and draws upon our experience since 1997 with constraint-induced movement therapy in children with cerebral palsy.

a new treatment involving bimanual (hand-arm bimanual intensive therapy (habit). the protocols have been developed at columbia university to be child friendly and draws upon our experience since 1998 with constraint-induced movement therapy in children with cerebral palsy. the interventions are performed in a 15 day day-camp setting with several children and at least one therapist per child. we have conducted 24 day camps to date since 2002, and are now collaborating with clinicians worldwide to expand our treatment availability. the aim is to promote the use of and improve the coordination of movement of both hands together. participation is free. please check out our website for more information: http://www.tc.edu/centers/cit/.

Eligibility criteria:
inclusion criteria: willingness to agree to intervention and testing procedures and travel to the university for participation and testing. exclusion criteria: * health problems not associated with cp * uncontrollable seizures * visual problems that would interfere with carrying out the intervention or testing * botulinum toxin therapy in the upper extremity musculature during the last six months or who wish to receive it within the period of study

Keywords: cerebral palsy constraint-induced therapy constraint-induced movement therapy cp hemiplegia hand forced use motor control children habit hand-arm bimanual intensive therapy bilateral training bimanual training functional therapy physical therapy occupational therapy intensive pediatric development upper extremity hemiplegic
psychosocial factors related to compliance with treatment with biphasic insulin analogues

Conditions: Diabetes; Diabetes Mellitus, Type 2

Summary: this study is conducted in europe. the aim of this study is to investigate psychosocial factors related to compliance with treatment with biphasic insulin analogues.


Eligibility criteria:
inclusion criteria: * patients with type 2 diabetes in whom therapy with biphasic insulin analogues was started
perioperative changes of cerebrovascular autoregulation and association with cognitive function

Conditions: Cognitive Function Abnormal; Anesthesia; Surgery

Summary: cerebral blood flow is tightly regulated to ensure constant cerebral perfusion independently from systemic blood pressure fluctuations. this mechanism is termed cerebrovascular autoregulation and preserves adequate cerebral perfusion in a range between 50 and 150 mmhg of cerebral perfusion pressure. upper and lower autoregulatory limits may vary individually. beyond the autoregulatory range the protective autoregulatory response is lost, facilitating cerebral ischemia or hyperemia. the cerebrovascular response may be altered during general anesthesia, through direct effects of anesthetic agents on the vascular tone, changes of arterial partial pressure of carbon dioxide or the administration of vasoactive substances. the association of perioperative impairment of cerebral autoregulation and postoperative cognitive function has been discussed controversially.

* continuous monitoring of cerebrovascular autoregulation using the correlation method * based on near-infrared spectroscopy and invasive blood pressure measurement an index (cox) will be calculated * autoregulation monitoring from anesthesia induction until emergence from anesthesia * assessment of preoperative cognitive function during preanesthesia evaluation or on the day before surgery * assessment of postoperative cognitive function between day 3 and 14 following surgery * evaluation of subjective cognitive complaints or attention deficits 3 months after surgery

Eligibility criteria:
inclusion criteria: * elective major non-cardiac/non-vascular surgery * anticipated surgical duration \>120 minutes * age \>= 60 years * indication for invasive blood pressure measurement * native german speaker exclusion criteria: * history of cerebrovascular disease * preexisting cognitive impairment * history or presence of neurological disease
vitamin d versus placebo in the treatment of vague musculoskeletal pain in children

Conditions: Hypovitaminosis D

Summary: other studies suggest that low vitamin d levels may contribute to musculoskeletal pain. hypothesis: administration of oral vitamin d supplements will improve vague musculoskeletal pain in children.


Eligibility criteria:
inclusion criteria: * ages 5-14 * healthy * vague musculoskeletal pain without diagnosis exclusion criteria: * medications (steroids, seizure medications, birth control pills or shot) * endocrinopathies
early pp with hfnc versus hfnc in covid-19 induced moderate to severe ards

Conditions: Prone Positioning; High Flow Nasal Cannula; Acute Respiratory Distress Syndrome; Corona Virus Infection

Summary: coronavirus disease 2019 (covid-19) is an emerging infectious disease that was first reported in wuhan, china, and had subsequently spread worldwide. twenty-nine percent of covid-19 patients may develop ards. based on the potential beneficial mechanisms of hfnc and pp, whether early use of prone positioning combined with hfnc can avoid the need for intubation in covid-19 induced moderate to severe ards patients needs to be further investigated.


Eligibility criteria:
inclusion criteria: * covid-19 induced adult ards patients admitted to the medical icu * pao2/fio2 is less than 200mmhg or fio2 ≥ 0.4 is required to maintain spo2 at 88-93% on hfnc treatment exclusion criteria: 1. if the patients have a consistent spo2\ 40/min, paco2\> 50mmhg / ph\<7.30, and obvious accessory respiratory muscle use); 2. immediate need for intubation (pao2/fio2\< 50mmhg or spo2/fio2 \<90, unable to protect airway or mental status change); 3. unstable hemodynamic status(sbp\<90mmhg, mbp below 65 mmhg or requirement for vasopressor); 4. unable to collaborate with hfnc/pp with agitation or refuse hfnc/pp. 5. chest trauma or any contraindication for pp 6. pneumothorax 7. age \< 18 years
selective tibial nerve block vs local infiltration analgesia after prothetic knee surgery

Conditions: Postoperative Pain; Knee Osteoarthritis

Summary: patient suffer from moderate posterior knee pain after tka despite injection of local anesthetic around the femoral or saphenous nerves. indeed, the posterior part of the knee is innervated by the sciatic nerve. this nerve is not routinely blocked as clinicians fear to produce a motor block of the leg that might impair the postoperative assessment. an analgesic alternative is the infiltration of the knee with local anesthetics performed by the surgeon. recently a trial(1) demonstrated that a selective tibial nerve block provides an effective analgesia without a motor blockage when compared with a sciatic nerve block. the objective of this randomized controlled double-blinded trial is to assess whether a tibial nerve block is more effective for the postoperative pain than local infiltration analgesia when there are combined with an adductor canal block, without decreasing the functional parameters.


Eligibility criteria:
inclusion criteria: * patient scheduled for a total knee arthroplasty under spinal block. * patient with a weight above 40kg. exclusion criteria: * patient with asa iv status. * contraindication to spinal block, or peripheral nerve blocks. * neurological deficit of the lower limb. * patient with renal dysfunction. * patient with chronic pain, opioid consumption or alcohol consumption. * pregnancy.
study on the anti-hpa antibodies caused neonatal alloimmune thrombocytopenia in chinese pregnant women

Conditions: Neonatal Alloimmune Thrombocytopenia

Summary: this clinical study aims to investigate the anti-hpa antibodies caused neonatal alloimmune thrombocytopenia in chinese pregnant women. the survey and data collect will help form an appropriate clinical screening procedure


Eligibility criteria:
inclusion criteria: * 12-28 weeks pregnant chinese women * between jan 1, 2017 and dec 31, 2018 exclusion criteria: * not willing to participate in this study * plan to terminate pregnancy early

Keywords: neonatal alloimmune thrombocytopenia pregnancy human platelet allogantigen asian chinese
evaluate the safety of dexycu for the treatment of inflammation following ocular surgery for childhood cataract

Conditions: Cataract

Summary: a phase 3/4, prospective, randomized, active treatment-controlled, parallel-design, multicenter study to evaluate the safety of dexycufor the treatment of inflammation following ocular surgery for childhood cataract


Eligibility criteria:
inclusion criteria: * undergoing uncomplicated cataract surgery with or without a posterior chamber intraocular lens (iol) implantation. * if a contact lens is used for correction of post-operative aphakia, it must be a silicone elastomer lens or a rigid gas permeable lens (no water content). * other protocol-specified inclusion criteria may apply. exclusion criteria: * presence of clinically significant gastrointestinal, cardiovascular, hepatic, renal, hematological, endocrine, neurological, psychiatric, respiratory, or other medical condition that could increase the risk to the subject as determined by the investigator. * has a post-traumatic cataract. * presence of active or suspected viral, bacterial, or fungal disease in the study eye. * ocular hypertension with an iop in the study eye \>25 mmhg at screening with or without treatment with anti-glaucoma monotherapy. * subjects who have received a periocular corticosteroid injection in the study eye in the 3 months prior to screening. * subjects who have received any intravitreal corticosteroid delivery vehicle (eg, retisert®, ozurdex®, iluvien®) in the study eye at any time. * other protocol-specified exclusion criteria may apply

Keywords: pediatric cataract
the effect of non-surgical periodontal therapy on adverse birth outcomes randomized controlled trial

Conditions: Birth Weight; Birth, Preterm

Summary: the main objective of this study is to determine whether the provision of non-surgical periodontal therapy to pregnant women with periodontitis is effective in reducing the incidence of low birth weight, preterm birth and still birth when compared to pregnant women with periodontitis but who will be provided with oral hygiene instructions alone.

approximately two-thirds of pregnant pakistani women suffer from periodontal disease a common inflammatory disease of the soft tissues surrounding the tooth. it was demonstrated that periodontitis among pregnant women is significantly associated with preterm birth and low birth weight. pakistan has a high prevalence of these adverse birth outcomes therefore; identifying an intervention is of prime importance and may have social and economic benefits. non-surgical periodontal therapy is affordable and amenable to people and thus seems to be an intervention which may prove to be of benefit in a population where the dental services are available. it has been recommended in systematic reviews and meta analysis that randomized controlled trials are now required to establish whether the removal of inflammatory factors by scaling and root planning are effective in reducing adverse pregnancy outcomes such as preterm birth and low birth weight.

Eligibility criteria:
inclusion criteria: * pregnant woman presenting to the obstetric clinic at the aga khan hospital for women, karimabad or the aga khan hospital for women and children, kharadar. * participant should be between the ages of 18 and 35 years * exhibiting at least 2 sites with 2mm or more periodontal probing depth. * planning to deliver the baby at the above mentioned facilities so that the outcome can be observed and measured. * singleton pregnancy. * willing to get nspt done between 20 to 28 weeks of gestation. * at least 20 teeth present in the mouth so that periodontal scoring could be done. exclusion criteria: * tobacco or alcohol use. * genitourinary tract infection or any systemic infection. * obstetric disorders such as gestational diabetes or placenta previa or pre-eclampsia or eclampsia etc. * chronic disease such as diabetes or blood pressure.